Minimally Invasive Heart Surgery
What is minimally invasive heart surgery?
Minimally invasive heart surgery entails operating
on the heart (2-3 inches) with long-handled, tiny
surgical instruments inserted through small incisions
in the chest as opposed to traditional open-heart
surgery, which requires a sternotomy (a 10-12
inch incision through the sternal bone) to access
the heart. Because the minimally invasive approach
"invades" the body less than a standard
open-heart procedure, you experience significant
benefits as a result.
Penn Cardiac Care Surgeons perform the following
procedures using minimally invasive techniques:
- Aortic valve replacement
- Atrial septal defects
- Coronary bypass
- Mitral valve repair and replacement
- Patent foramen ovale (hole in the heart)
Our surgeons tailor each operation according
to your unique needs and condition. Your doctors
may choose one or several techniques during surgery
to provide the most benefit for you.
What are the benefits of minimally invasive
surgery?
Minimally invasive surgery performed through a
significantly reduced incision area provides less
trauma and blood loss. Though each patient's experience
may vary, minimally invasive surgery may result
in the following benefits:
- Lower risk of infection
- Fewer medications
- Pain and scarring
- Quicker recovery
- Shorter hospital stay
Is there any increase in risk with these procedures?
There is no increased risk with minimally invasive
procedures. The operations within the heart are
performed with the same techniques used in standard
heart surgery, just via smaller, less painful
incisions.
Beating heart or "off-pump" surgery
Using sophisticated technology most coronary bypass
procedures, including multivessel bypass operations,
can be performed "off-pump" or while
the heart is still beating. This avoids the need
to stop and restart the heart, as is the case
when one is placed on the heart-lung machine during
standard heart surgery. Avoiding the heart-lung
machine results in fewer blood transfusions and
quicker recovery.
Recovery
Following surgery, all patients are closely monitored
in the intensive care unit. Generally you will
be awake shortly after surgery and can expect
to sit up in bed the night of surgery, sipping
fluids. Like most patients, you can move out of
bed to a chair or take short walks the next day.
Medication will be prescribed, adjusted or discontinued
depending on your condition. Patients receive
physical rehabilitation while in the hospital
and are usually ready to go home in three or four
days after surgery. Although the speed of recovery
varies, patients can expect to resume their lifestyle
within two or four weeks of their operation.
Minimally invasive valve surgery
Penn Cardiac Care at Penn Presbyterian was the first
program in the region to use a voice-activated,
robotic device during mitral valve operations
and atrial septal repairs. This arm facilitates
these procedures by controlling a camera positioned
inside the chest, providing a bird's eye view
of the heart's interior on a video screen located
adjacent to the operating table. To peer more
closely into the chest, the surgeon states commands,
instructing the robot to change positions. The
surgical team thereby performs the procedure through
smaller incisions.
Using state-of-the-art equipment and techniques,
Penn Cardiac Care surgeons, with the assistance
of a specialty team of cardiac anesthesiologists
and specially trained nurses, perform mitral valve
repair or replacement through a small right chest
incision, and aortic valve replacement through
a small, partial sternotomy approach.
In the past five years, our team has performed
approximately 250 valve surgeries with outstanding
success.
Coronary artery bypass surgery
Our cardiothoracic surgeons are utilizing the
latest research on arterial conduits for bypass
grafts. Recent data has shown that arteries remain
open longer than veins when used as bypass coronary
vessels.
Speak to your doctor to learn if you are a candidate
for bypass surgery.
See also: Minimally Invasive
Vein Harvesting
Surgeons
Michael
A. Acker, MD
Joseph
E. Bavaria, MD
Clark
W. Hargrove III, MD
Rohinton
Morris, MD
Alberto
Pochettino, MD
Y.
Joseph Woo, MD
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